Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Melbourne, VIC.
Med J Aust. 2010 Sep 6;193(S5):S83-7. doi: 10.5694/j.1326-5377.2010.tb03935.x.
To test the feasibility and acceptability of a telephone-based program to screen survivors of colorectal cancer (CRC) for distress, and to refer distressed patients to their treating health service.
DESIGN, SETTING AND PARTICIPANTS: A prospective, multicentre study involving 59 patients with CRC recruited from six public and private health services in Melbourne, Victoria, from 15 June 2008 to 22 September 2009. Patients who had completed adjuvant chemotherapy for CRC were contacted (7-10 days after recruitment [outcall one] and again 4 weeks later [outcall two]) by the Cancer Council Victoria's helpline nurse, and screened for distress with the Distress and Impact Thermometer (DIT); participants were given tailored information and support and those with distress scores of > or = 5, and impact scores of > or = 4, were referred for follow-up. Telephone interviews were conducted 4 weeks after outcall two. Participating helpline and health service staff were surveyed on the feasibility and acceptability of the service.
Anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS).
Of the 59 patients (87%) who agreed to participate, 63% were men; their mean age was 59 years (SD, 9.5 years). HADS depression decreased significantly from baseline (mean score, 4.93; SD, 4.22) to follow-up (mean score, 3.84; SD, 4.10; Z = -2.375; P = 0.02). However, there was no significant difference in HADS anxiety between baseline (mean score, 5.29; SD, 4.11) and follow-up (mean score, 4.78; SD, 3.65). Outcall one generated two referrals (4% of participants) and outcall two generated four referrals (8%); five of these six participants took up the referrals. Satisfaction with the program among participants was high; 82% found outcall one "quite or very helpful" and 79% found outcall two "quite or very helpful". Helpline and health service staff reported a straightforward process that did not adversely affect workloads.
This model of care carries the potential to meet ongoing psychosocial needs of survivors of CRC.
测试一种基于电话的方案对结直肠癌（CRC）幸存者进行困扰筛查并将困扰患者转介至治疗保健服务的可行性和可接受性。
设计、地点和参与者：2008 年 6 月 15 日至 2009 年 9 月 22 日，从维多利亚州墨尔本的六家公共和私人卫生服务机构招募了 59 名 CRC 患者，进行了一项前瞻性、多中心研究。在招募后 7-10 天（呼出一）和 4 周后（呼出二），癌症理事会维多利亚州的热线护士通过电话联系了这些患者，并使用困扰和影响温度计（DIT）对困扰进行筛查；向参与者提供了个性化的信息和支持，对于困扰评分≥5 且影响评分≥4 的患者，将其转介进行后续治疗。在呼出二 4 周后进行了电话访谈。对热线和卫生服务工作人员进行了关于服务可行性和可接受性的调查。
焦虑和抑郁，采用医院焦虑和抑郁量表（HADS）进行测量。
在同意参与的 59 名患者中（87%），63%为男性；他们的平均年龄为 59 岁（标准差，9.5 岁）。HADS 抑郁评分从基线（平均评分 4.93；标准差，4.22）显著下降到随访时（平均评分 3.84；标准差，4.10；Z=-2.375；P=0.02）。然而，HADS 焦虑评分在基线（平均评分 5.29；标准差，4.11）和随访（平均评分 4.78；标准差，3.65）之间无显著差异。呼出一产生了两个转诊（占参与者的 4%），呼出二产生了四个转诊（8%）；这六个参与者中的五个接受了转诊。参与者对该方案的满意度很高；82%的人认为呼出一“相当或非常有帮助”，79%的人认为呼出二“相当或非常有帮助”。热线和卫生服务工作人员报告说，这一过程简单直接，不会对工作量产生不利影响。
这种护理模式有可能满足结直肠癌幸存者的持续心理社会需求。
